Saturday, September 17, 2005

NYC says Monsey rabbi will stop circumcisions

A Monsey rabbi linked to three infants who contracted herpes has agreed to stop performing oral suction circumcisions in New York City until a religious panel investigates the method, the city announced yesterday.

Yitzchok Fischer has been under a temporary restraining order issued by a New York City court not to perform oral-suction circumcisions in the five boroughs. Rockland health officials have placed a separate ban on the rabbi.

Fischer uses his mouth to suction blood from the wound after he removes the foreskin. The centuries-old ritual, called metzizah bi peh, is used by Hasidic and ultra-Orthodox Jews.

Fischer and the circumcision method came under scrutiny when a Manhattan newborn died of herpes in November, and his twin was diagnosed with the virus. A Staten Island newborn circumcised by Fischer was diagnosed with herpes in November.

The strain of herpes found in the infants is transmitted orally.

The New York City Department of Health and Mental Hygiene had been trying for months in court to stop Fischer from using oral-suction circumcision.

Yesterday, an agency spokeswoman said an agreement had been reached.

"Rabbi Fischer has agreed to stop performing metzizah bi peh in NYC pending an investigation being conducted by the Rabbinical Court of the Central Rabbinical Congress," spokeswoman Sandra Mullin said in a statement.

Fischer's lawyers, Mark J. Kurzmann and his son Hillel M. Kurzmann of Pearl River, said the rabbi agreed to the religious tribunal request.

"Rabbi Fischer has been asked by the rabbinical court to refrain from practicing metzizah bi peh and agreed," Mark Kurzmann said.

Kurzmann said no conclusive medical evidence has been shown that the infants contracted the virus from the rabbi. The rabbi took a herpes test, but the results have not been released by the state or city.

"I remain as convinced as ever that a thorough investigation will confirm that my client was not the source of any of the three unfortunate infections," he said.

The New York state Health Department had rescinded its ban on Fischer and joined New York City's plan for a committee of rabbis and medical personnel to review the oral-suction procedure and come up with guidelines.

Rockland Health Commissioner Joan Facelle was awaiting guidance from the state on how to proceed with the county's ban.


I've got an idea.
Instead of the Theives blog, why not call it "The absolute most horrific moments of Judaism blog?" I think it fits.


Metzitzah update
Two years of research have yielded the following:
1) Neonatal herpes is typically the result of a primary infection. The definition of Primary infection is: "virus positive seronegative" i.e., no antibodies to indicate a previous infection.
2) "Asymptomatic primary infection is the rule rather than the exception".

- Whitley RJ, Kimberlin DW, Roizman B. Herpes simplex viruses. Clin Infect Dis. 1998 Mar; 26(3):541-53

3)An 18 year study of 58,000 women indicates primary infection carries more than double the risk of neonatal infection, than non- primary or recurrent HSV.
) Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L, Effect of Serologic Status and Cesarean Delivery on Transmission Rates of Herpes Simplex Virus From Mother to Infant JAMA 2003 Jan 8;289(2):203-209

4) Timing of 1-28 days is typical of maternally transmitted herpes.(Some other sources say as late as 8 weeks)
AAP Pediatric Redbook, & Kimberlin DW. Neonatal herpes simplex infection. Clin Microbiol Rev. 2004 Jan;17(1):1-13. These 2 sources BTW are mentioned in NYC DoH 2005 Alert #46. The author of the Alert cites these sources regarding Acyclovir antiviral treatment but ignores the rest of the paper which describes their cases as typical maternally transmitted NHSV.

4) Tendler's paper used 23 year old American HSV-1 statistics to blame the Mohel for orally infecting newborns in 7 Israeli and 1 Canadian cases. Current information indicates:

62.5% of known neonatal herpes types were HSV-1

Kropp RY., et al. Neonatal Herpes Simplex Virus Infections in Canada: Results of a 3-Year National Prospective Study, Pediatrics 2006 117:1955-1962

75% of genutal herpes in Tel Aviv is HSV-1.
Samra Z, Scherf E, Dan M. Herpes simplex virus type 1 is the prevailing cause of genital herpes in the Tel Aviv area, Israel. Sex Transm Dis. 2003 Oct;30(10):794-6.
Every test that could have proven or disproven the source was avoided by Temndler and the NYC DoH. Follow up serology, serologic testing for discordant partners, DNA comparison where one Mohel was accused in two cases, etc. All were meticulously avoided.

Additionally none of the authors have ever done a paper on neonatal herpes, but many have been critical of traditional circumcision.

This does not include many of the lies concerning history in the paper, i.e., the Chasam Sofer who died in 1839, was influenced by Ignacz Semmelweis' May 1847 discovery of disease transmission (in an obstetrics ward, not because a baby got tuberculosis from a mohel) and therefore permitted instrumental suction, even thouh the instrument was not invented until 1887.


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